Provider Demographics
NPI:1164571774
Name:MILETI OPTICAL COMPANY INC.
Entity Type:Organization
Organization Name:MILETI OPTICAL COMPANY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:MILETI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-884-6333
Mailing Address - Street 1:5957 STATE RD
Mailing Address - Street 2:
Mailing Address - City:PARMA
Mailing Address - State:OH
Mailing Address - Zip Code:44134-2868
Mailing Address - Country:US
Mailing Address - Phone:440-884-6333
Mailing Address - Fax:
Practice Address - Street 1:5957 STATE RD
Practice Address - Street 2:
Practice Address - City:PARMA
Practice Address - State:OH
Practice Address - Zip Code:44134-2868
Practice Address - Country:US
Practice Address - Phone:440-884-6333
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-10
Last Update Date:2013-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3064-S156FX1800X
OH01374237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Multi-Specialty
No237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0630880001Medicare NSC